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As lenalidomide has promising single agent activity in multiple relapsed <jats:styled-content style=\"fixed-case\">HL<\/jats:styled-content>, we replaced bleomycin in <jats:styled-content style=\"fixed-case\">ABVD<\/jats:styled-content> with lenalidomide in this phase\u2010I trial. Patients aged \u226560\u00a0years with early\u2010unfavourable\u2010 or advanced\u2010stage <jats:styled-content style=\"fixed-case\">HL<\/jats:styled-content> (Eastern Cooperative Oncology Group performance status \u22642, Cumulative Illness Rating Scale for Geriatrics score 0\u20137) received 4\u20138 cycles of <jats:styled-content style=\"fixed-case\">AVD<\/jats:styled-content> (doxorubicin, vinblastine, dacarbazine) and lenalidomide in escalation with overdose control. Dose\u2010limiting toxicities (<jats:styled-content style=\"fixed-case\">DLT<\/jats:styled-content>s) included thromboembolism \u2265grade 2, severe haematological toxicity, neutropenic fever and prolonged therapy delay. Twenty\u2010five patients with a median age of 68\u00a0years were included, 68% had advanced\u2010stage <jats:styled-content style=\"fixed-case\">HL<\/jats:styled-content>. A pre\u2010defined stopping criterion for dose escalation after <jats:styled-content style=\"fixed-case\">DLT<\/jats:styled-content> evaluation of 20\/24 patients suggested a recommended phase <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> dose (<jats:styled-content style=\"fixed-case\">RPTD<\/jats:styled-content>) of 20\u00a0mg. <jats:styled-content style=\"fixed-case\">DLT<\/jats:styled-content>s occurred in 10\/24 evaluable patients, all treated with \u226520\u00a0mg, however, median relative dose intensity was 97% (interquartile range 49\u2013104%). Grade 3 or higher toxicities occurred in all 22 patients at \u226520\u00a0mg lenalidomide but no treatment\u2010related deaths occurred. Overall response rate was 80% for all patients (20\/25) and 86% (19\/22) at \u226520\u00a0mg lenalidomide. Three\u2010year estimates for progression\u2010free survival and <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> were 69\u00b77% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 50\u00b73\u201389\u00b71%) and 83\u00b78% (95%\u2010<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 69\u00b73\u201398\u00b74%), respectively. In conclusion, <jats:styled-content style=\"fixed-case\">AVD<\/jats:styled-content> with lenalidomide 20\u00a0mg is feasible and highly effective in older <jats:styled-content style=\"fixed-case\">HL<\/jats:styled-content> patients.<\/jats:p>","DOI":"10.1111\/bjh.15741","type":"journal-article","created":{"date-parts":[[2018,12,28]],"date-time":"2018-12-28T08:13:18Z","timestamp":1545984798000},"page":"42-52","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Doxorubicin, vinblastine, dacarbazine and lenalidomide for older Hodgkin lymphoma patients: final results of a German Hodgkin Study Group (<scp>GHSG<\/scp>) phase\u2010I trial"],"prefix":"10.1111","volume":"185","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6432-0981","authenticated-orcid":false,"given":"Boris","family":"B\u00f6ll","sequence":"first","affiliation":[{"name":"German Hodgkin Study Group (GHSG) Department of Internal Medicine 1 University 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